HomeMy WebLinkAboutBLD2024-00421 Deck - BLD Application - 4/1/2024 MASON COUNTY COMMUNITY SERVICES PermitNo:16UW24—b" (W-1
PERMIT ASSISTANCE CENTER: V E!
•BUILDING•PLANNING-PUBLIC HEALTH•FIRE MARSHAL
615 W.Alder Street,Shelton.WA 98594
Phone Shelton:(360)427-9670 ext 352•Fax:(360)427-7798 Phone (y ny f
BeHair-(360)275-4467•Phone EJma(360)482-5269 APR r24
O 1
BUILDING PERMIT APPLICATION 615 W. Alder sb-eet
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: NAME:^0&p
MAILING ADDRESS: ; IvcfMAMIN ADDRESS: C•, ri
CITY:A jq J4,f.a1 STATE:J�ZIP: CITY: STATE: ZIP: �,v'^ p
PHONE#1: to =, -�I 06 PHONEt/43-37�yCELL:
PHONE#2: EMAIL: wk e�tJ..(, � z
EMAIL: L&I REG# G .¢�QQl G
PRIMARY CONTACT: OWNER'& CONTRACTO OTHER❑
NAME VAb MAIL
MAILIN DRESS a ITY STATE yl(N ZIP
PHONE 3150' CELL
PARCEL INFORMATION: nn nn
PARCEL NUMBER(12 Digit Number)_�j p� 3 2� J(�"S�d�I ZONING I .
LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT LO
SITE ADDRESS 2191 E �-, CITI'_ yl 1'o w
DIRECTIONS TKO"SITE ADDRESS NI L R 9�,ky ) g -b M L S t Sf rt`�I G.
Drl k.RJhf'S — e
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO IS SNOW LOAD:---psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: p,.k jI Char apply):
SALTWATER❑ LABE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW❑ ADDITION❑ermd ALTERATION❑ REPAIR❑ ID ❑
USE OF STRUCTURE(R 4 Goraga Come W Bldg.Etc) I n&Ak �t Jn C'Off/eV Q
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS_A!�rl
BEATID STRUCTURE? YES(whaleBldg)❑ If'E3(Part[s]alBldgJ❑ No a
DESCRIBE WORK L � �1 (eye r OV / /� GLr d lb SyCT-
SQUARE FOOTAGE:(propare�
1ST FLOOR sq.ft 2ND FLOOR sq.ft 3RD FLOOR sq.fL BASEMENT sq.L
DECK_sq.ft COVERED DECK sq.R STORAGE sq.ft. OTHER sq.ft
GARAGE sq.R.Attached❑ Detached❑ CARPORT sq.ft.Attached❑ Detached❑
MANUFAC ORMATION: *4 COPIES OF THE FLOOR PLAN T F,D*
MAKE MOD YEAR LENG
WID BEDROOMS BATH SERIAL NUMB
F2 VIERONMENTAL HEALTH: "
SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING❑
PLUMBING IN STRUCTURE? YES❑ NOg Ifyes,attach completed Water Adequ g Form
PERDAFTER/FOUNDATION DRAINS PROPOSED? YES❑ NO;K EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS t-�o — TOTAL BEDROOMS
OWNER acknowledges that submission of inaccurate information may result in a stop work order or permit revocatior.Acknowledgement of such is by
signature below.I declare that I am the owner and I further declare that I am entitled to receive this permit and to do the work as proposed.I have
obtained permission from all the necessary parties,Including any easement holder or parties of interest regarding this project.The owner or legal
representative,represents that the Information provided is accurate and grants employees of Mason County access to the above described property
and stru=re(s)for review and inspection.This permitlapplication becomes null&void If vrork or authorized construction is not commenced within 180
days or If construction work Is suspended for a period of 180 days.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.09.42)
X _QC/-61-a4d(-1
'Stnature of OWNER(Must be signed by the OWNER I Date
'DEPARTNIENTAL_REVIEW=:. :APPROVED' DAT _DEIZIED_ :.DATE -=TAGS/NOTES/CONDITIONS
BUILDING DEPARTM=
PLANING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
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ALLEY 125. ----_ I
Date:09-29-2mm c
env APPROX. LOCATION
A OF 12" HANCOR Sca/e:4•. 1'-m' 6
DBL WALL PIPE Drawn br GJA
FOR RAIN WATER
RUN-OFF Job:20me-81 y
sip 51 TE PLAN SITE �LL
wl( 3e r Scale: I" • 20'-0"
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MASON COUNTY Date 1" E I V E D
COMMUNITY SERVICES DEPARTMENT APR 0 12024
,a
BUILDING•PLANNING•FIRE MARSHAL
615 W. Rdar Street
Mason County Bldg.8,615 W.Alder St
1 Shelton,WA 98584 www.co.mason.wa.us 360-427-9670 ext 352
Permit#: �a�oa d V
Property owner's Authorization Letter
. ^(Prim Property,Owners Name/Firm/Organization)
Hereby Authorize: 1 Cirri
(Applicant-Name of Person to Sign Permit)
Representative of: —I'WiD (-) ( S�vVU06�
(Applicant Company Name/Organization)
To apply for, sign,and pick-up building permits for the following proposed work:
(Brie,f Description of A'ork to be Done)
Job Location• . Z, 0kK' V-' W04- qV-:VqZ
(Property Sik A ddress)
As property owner(s),1.(we)hereby grant permission to the applicant referenced above to apply for,sign,and pick-
up the building permit for the work as indicated above.All work performed must meet all provisions of the
Building Codes and the Laws of Mason County and the State of Washington,as applicable,whether specified or
not.Residential Contractors are required to have a current State of Washington Contractors License(RCW 18.27).
' jz,,y
(Pro rty Owner Signature) (Date)
Rev.0311 a,7016 jibn